A rare presentation of ruptured abdominal aortic aneurysm leading to aortoduodenal syndrome.

Duodenal obstruction is a rare complication of abdominal aortic aneurysm. Obstruction developing acutely from ruptured abdominal aortic aneurysm (RAAA) is exceedingly rare. We present a case of gastroduodenal outlet obstruction developing as the primary presentation for RAAA and a discussion of the relevant literature pertaining to the gastrointestinal complications related to the presence of intact and RAAA. Relief of obstruction is focused on direct aortic replacement with further evaluation of the upper gastrointestinal tract if indicated based on intraoperative findings.